Women´s Experiences in Accessing Maternal and Child Health Services During the Period of the Armed Conflict in the North of Mali

Abstract

Abstract:Background: During the year 2012 armed conflict in the northern regions of Mali, health care services were no longer able to run in the normal way and women's access to health services became a critical issue in those regions. Objective: The aim of this study was to explore the women's experiences in accessing maternal and child health services during the period of the armed conflict in the north of Mali. Methodology: The interviews were conducted with 28 married women between September and October 2013. The women were recruited in Sévaré's refugee camp and by snowball sampling from the neighborhood village of Waîlirdré. Results: 27 multiparous women and one childless woman were interviewed. They were all married, between 20 and 56 years old. During the armed conflict, several health facilities were destroyed, the few that could offer some health services were lacking of medicines and personnel. Doctors, nurses and midwives have left. Some pregnant women have had severe complications, or miscarriages. Some died during the delivery at home or in the maternity clinics because they were brought too late. Newborns died during home delivery and also some children less than 5 years old died because of the lack of healthcare services. Some women were abused sexually by the Islamist Jihadists who forced them to submit fundamentalist Islamic rules and prohibited them to access to family planning services. During the armed conflict, women used more traditional medicines for child healthcare. They expressed their fear about their health and that of their children once they have returned home. Conclusion: Women had difficulties to access to healthcare services in the northern regions of Mali. The atrocities of Islamist Jihadists against the population and the destruction and looting of the healthcare facilities had considerably reduced access to health services during the armed conflict. There is urgent need for women's and children's healthcare services in these regions. Programmes to support sexually abused women also need to be the health care priorities.

C’est vraiment compliqué: a case study on the delivery of maternal and child health and nutrition interventions in the conflict-affected regions of Mali

“…Access to services for individuals in Northern Mali is limited and organizations report that women attempting to access maternal and child health care in Northern Mali are concerned since there are reports that Jihadists monitor health visits to ensure women don't access family planning services [2]. Estimates from the most recent humanitarian response plan state that, at present, 1.7 million individuals have compromised access to health care [6].…”

“…1 Centre for Global Child Health, the Hospital for Sick Children, Toronto, Canada. 2 Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technology of Bamako, Bamako, Mali. 3 University Clinical Research Center, Bamako, Mali.…”

“…The collapse of Libya in 2011 dispersed vast numbers of armed Jihadist groups and their weapons to other countries in the region, including Mali. This influx further exacerbated existing ethnic tensions in the country, with violent conflict eventually erupting between local ethnic minorities and the Malian government in Northern Mali in January 2012 [2]. This violence was the culmination of historical tensions between the government and the Mouvement National pour la Libération de l'Azawad (MNLA), a group comprised of ethnic minorities of northern Mali, fighters returning from Libya, and deserting soldiers from the Malian army [3].…”

“…In March 2012, the government's inability to effectively address the violence and the evolving occupation of Northern Mali by Jihadists resulted in a coup d'état that exacerbated the instability and led the national army to withdraw from the northern regions, resulting in the rebel domination of most large cities in all four northern regions [5]. The MNLA proclaimed the independence of northern Mali shortly after, but by mid-2012 a wider Jihadist-nationalist conflict emerged between the population, the MNLA, AQIM/MOJWA, and Ansar Dine [2]. Violence escalated in the region during the second half of 2012, and in January 2013, by request of the Malian government and the Economic Community of West African States (ECOWAS), French military intervention began, soon resulting in the government reasserting control of the northern region and in a short-lived cease-fire and realignment of the MNLA with the Malian government in the fight against the Jihadists.…”

Childbirth Experiences and Delivery Care During Times of War: Testimonies of Syrian Women and Doctors

“…It was not surprising to see that the main issue experienced by women and doctors was the inaccessibility to the hospital. Many other authors have reported on the point of accessibility of care in conflict-affected countries (18)(19)(20). Damascus at the time of data collection (2012-2014) was not safe due to random mortars hitting the city and many governmental checkpoints in place.…”